By Glenn Ellis
George Curry Media Guest Columnist
Glenn Ellis
Not so long ago, treating Hepatitis C was a decidedly bleak affair. And the prospect of curing the potentially life-threatening virus, or infection – which causes liver disease and inflammation of the organ – was a long shot. Consequently, many patients opted to forgo treatment.
Hepatitis C virus (HCV) is transmitted by exposure to blood or other bodily fluids of people who are infected. Hepatitis C is a serious liver disease that results from infection with the Hepatitis C virus. The virus can make some people very sick, and over time can cause serious health problems, including liver damage and even liver cancer.
Risk factors for having a Hepatitis C infection include: injection drug use, blood transfusion prior to 1992, being on longterm hemodialysis, incarceration, using intranasal drugs, having an unregulated tattoo and exposure to blood as a health worker.
Approximately 2.7 million Americans have a chronic Hepatitis C infection. Between 1 and 5 percent of these people will die from cirrhosis or liver cancer. A resurgence of injection narcotic use has also lead to infections in young adults under the age of 30 in the U.S.
Though the virus wasn’t discovered until 1989, public health data suggest it was being transmitted even earlier. People born from 1945 to 1965 (baby boomers) are five times more likely to have Hepatitis C. Unfortunately, African Americans born during these years have twice the rates as other baby boomers. While African Americans represent only 12 percent of the U.S. population, they make up roughly 22 percent of the estimated 3.2 million persons with chronic HCV infection. Moreover, chronic liver disease, often Hepatitis C-related, is a leading cause of death among African Americans ages 45-64.
Hepatitis C is more prevalent among African Americans than among persons of any other racial group in the United States. Strategies to improve outcomes in African Americans include higher doses of current medications, medications with fewer adverse events, and new experimental molecular therapies.
African Americans are usually underrepresented in clinical trials of treatment for acute and chronic HCV infection, even though their prevalence of chronic HCV infection is higher than among Whites. African American subjects currently represent only 5 percent to 10 percent of participants in clinical trials involving HCV infection.
Interferon-based treatment resulted in cure rates among African Americans that were significantly lower than among Caucasian populations, highlighting the need for new treatment options to increase the possibility of cure for all patients.
Recent advancements in the fight against hepatitis C have transformed the disease from one that can, at best, be controlled to one that can be cured for a majority of people who have it. The past four years have seen significant advances in HCV treatment, with several new drugs coming to market that can now cure HCV in a shorter period of time and with fewer side effects.
A downside to the massive drug development efforts that proved so successful is the hefty cost of treatment. What’s hefty? Try $1,000 per pill, taken once per day, for 12 to 24 weeks. A three-month course of Hepatitis C treatment typically runs between $80,000 and $120,000.
About 1 million Americans with HCV are thought to be covered by Medicaid, a joint state-federal program for the poor. By law, Medicaid and Medicare are required to cover medically necessary treatments; they can’t exclude an entire class of medications that are proven effective for cost considerations alone.
After legal battles and lobbying efforts, thousands of people with hepatitis C are gaining earlier access to expensive drugs that can cure this condition. States that limited access to the medications out of concern over sky-high prices have begun to lift those restrictions, many under the threat of litigation.
The drugs in question – Sovaldi and Harvoni from Gilead Sciences, Viekira Pak from AbbVie Inc., and Zepatier from Merck & Co., among others – eliminate the Hepatitis C virus more than 90 percent of the time, a cure rate almost double that of earlier therapies. The latest HCV drug to enter the market, Gilead Sciences’ Epclusa, received approval from the Food and Drug Administration last week.
Remember, I’m not a doctor. I just sound like one.
DISCLAIMER: The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.)
Glenn Ellis, is a regular media contributor on Health Equity and Medical Ethics. He is the author of Which Doctor?, and Information is the Best Medicine. Listen to him every Saturday at 9 a.m. (EST) on www.900amwurd.com, and Sundays at 8:30 a.m. (EST) on www.wdasfm.com. For more good health information, visit: glennellis.com